Step 1: Check Your Out-of-Network Benefits

Before submitting a superbill, contact your insurance company and ask the following:

Do I have out-of-network mental health benefits?

Some plans offer partial reimbursement for therapy sessions with an out-of-network provider.

What percentage of the session fee will be reimbursed?

Plans often cover a percentage after you meet your out-of-network deductible.

What is my out-of-network deductible?

This is the amount you must pay before your insurance starts reimbursing.

Is there a limit to how many sessions are covered per year?

Some plans cap the number of reimbursable therapy sessions per year.

Are there specific requirements for reimbursement?

Some plans require a diagnosis on the superbill. Others require pre-authorization or specific CPT codes.

Step 2: Request a Superbill from Your Therapist

Once you’ve confirmed your benefits, request a superbill from your therapist. A superbill typically includes:

Your full name and date of birth

Your therapist’s name, credentials, and NPI number

Your therapist’s license number and state of licensure

Your therapist’s office address and phone number

The date(s) of service

The session length and CPT code (e.g., 90837 for a 60-minute session)

The diagnosis code (if required by your insurance)

The total amount you paid for each session

Step 3

After receiving your superbill, follow your insurance company’s submission process:

Online Submission – Many insurance companies allow you to submit claims through their member portal.

Email/Fax Submission – Some plans accept claims via email or fax.

Mail Submission – If mailing, include a completed claim form (check your insurer’s website for this).

Pro Tip: Keep copies of all submitted documents for your records.

Step 4: Track Your Claim & Reimbursement

Insurance companies typically take 2-6 weeks to process claims.

If you do not receive reimbursement within the expected timeframe, call your insurance company to check the claim status.

If your claim is denied, ask for a detailed explanation and find out if you can appeal.

Step 5: Adjust for Future Sessions

If your insurance provides partial reimbursement, you can continue submitting superbills regularly (e.g., monthly).

If your claim is denied due to a missing requirement, discuss adjustments with your therapist to ensure future superbills meet your plan’s criteria.

Additional Tips:

✔ Use insurance terminology when speaking with your provider (e.g., “out-of-network behavioral health reimbursement”).

✔ Keep all documents organized for tax purposes if you deduct medical expenses.

✔ Some insurers require reimbursement via direct deposit—check your settings in your insurance portal